Healthcare Provider Details

I. General information

NPI: 1588857395
Provider Name (Legal Business Name): KRISTEN JEAN SPRATT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 WEDDINGTON RD
WEDDINGTON NC
28104-8318
US

IV. Provider business mailing address

1932 WEDDINGTON ROAD
WEDDINGTON NC
28105
US

V. Phone/Fax

Practice location:
  • Phone: 704-847-4000
  • Fax: 704-847-4001
Mailing address:
  • Phone: 704-847-4000
  • Fax: 704-847-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201962
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: